Search

Although there is an extensive psychoanalytic literature on perversion, and numerous articles about creativity, few authors have explored relations between creativity and perversion. In particular, the role of childhood trauma and its impact on object relations has not been examined in patients with perversions whose creativity is blocked. In association with preoedipal anxieties and fantasies, childhood trauma can not only contribute to the development of perversion, but can also inhibit or distort the creative process by establishing an inner world characterized by the presence of a threatening internal bad object and the elusiveness of an internal good object. Though it is essential to help these patients establish an identification with the phallic father, an internal good maternal object, in the form of a muse, needs to be retrieved to bring inspiration and reduce the anxieties generated by an internal bad object, thereby facilitating the pursuit of authentic creative work. A detailed case report illustrates how this theoretical perspective guided the treatment approach to a male patient with macrophilia who was struggling to realize his creative potential.

The concept of affirmative consent presumes a subject who is fully transparent to herself and who can anticipate the precise effects of her assent. This essay proposes limit consent, a concept that offers us different ways to think about the sexual—and about the analytic encounter. Limit consent involves a more nuanced negotiation of limits and becomes possible when the subject makes herself passible (Lyotard 1988) to an other—a condition that is neither active nor passive. Processes described in depth here suggest that passibility has ties to the rousing of infantile sexuality (Freud) and to the subject’s normative perversity (Laplanche). When the psychic economy of the infantile sexual is followed to its apex, a particular kind of state is produced that I call overwhelm—a word that is used here as a noun. Overwhelm is a state of dysregulation that can be confused with, but is not the same as, repetition compulsion. Overwhelm entails risk, and under some circumstances it may open up space toward significant psychic transformations. A detailed clinical example illustrates how overwhelm may make itself known in the clinical encounter, and how it can infiltrate the transference/countertransference. Specific technical suggestions are made regarding analytic work with overwhelm.

Over five years, from 1919 to 1924, Freud dealt with masochism in three texts written in close proximity: “A Child Is Being Beaten,” Beyond the Pleasure Principle, and “The Economic Problem of Masochism.” Initially Freud explains masochism as incestuous fixation on the father and regression to pregenital, sadistic ways of loving. Subsequently he considers it primarily as subservient to the death drive. This paper starts from an idea present in two of the three texts, but not developed by Freud, in which he refers to the role that the “qualitative” element of rhythm could play in the occurrence of pleasure in masochism. By means of this element traumatic aspects of the primary relationship with the object could be stored as fantasies in the body. In any staged masochistic fantasies of being beaten or in masochistic perversion, the pleasure of pain would lie in the attempt to “dream” the trauma not only in the imagination but also, “aesthetically,” in the body.

Several detailed analytic hours illustrate how, with the analyst's full participation, patients use the words, setting, and activity of analysis to gratify the very wishes they are analyzing, and so disavow the work of analysis. These gratifications, which are hidden in plain sight, are themselves disavowed in the apparent pursuit of analytic understanding. In this way the patient's and the analyst's use of the analytic situation becomes the fundamental resistance to the work itself. This process shares features in common with perversion. The painful but necessary task for both analyst and patient is to analyze this process as it is occurring, moment by moment, in the real time of the hour.

The analyst’s consulting room toilet lends itself to myriad uses in the context of the analytic relationship. It is a place where “dirty” secrets may be excitedly deposited and where perverse fantasies can be fueled and acted out, as illustrated in the analysis of Mr. D. This perverse use of the analyst’s toilet is contrasted with the case of Ms. C., whose anxieties about the destructiveness of her aggression led initially to a phobic avoidance of the toilet and then evolved toward its use as a container for parts of herself she felt were bad and unacceptable, thereby protecting the relationship with the analyst, who could not yet be trusted to receive and survive her projections. In these cases the toilet becomes quite concretely the location of the “toilet-breast” (Meltzer 1967), a means of preserving a more idealized relationship with the analyst.

This paper describes the difficulty of working with patients who have adopted conflict solutions common to perversion. These analysands' rapid shifts from one discontinuous mental state to another draw the analyst into a regressive transference/countertransference engagement characterized by alternations of actualized self and object representations. The analyst's disengagement from this regressive interaction is crucial, but difficult. A detailed clinical example illustrates the process of disengagement as well as the transformation of this transference into a more traditionally consolidated one. A technical approach is suggested and questions of representation and symbolization are explored.

This paper explores the transference dynamics and underlying fantasies of analysands whose characters have been shaped by conflict solutions common to perversion. Giving the impression of a serious engagement for therapeutic ends, these individuals live out in the treatment a sexualized enactment in which the analyst's interventions are transformed into a fetish. This enactment is designed to support a defensive effort to avoid external perceptions that trigger certain fantasies of danger, including that of castration. It is designed also to cancel out interventions of the analyst that become equated with these frightening fantasies. Since the analyst's efforts to explore and interpret this enactment are also turned into a fetish, such a transference poses grave difficulties for the analysis. A technical approach is suggested in which the analyst focuses on the contradiction itself, the operation of the disavowal, the fantasy of danger that motivates the persistent use of disavowal, and the underlying, often vengeful and envious wishes that contribute both to the undermining of the analysis and to the content of the fantasies of danger that provoke so much anxiety.

The role of perverse sexuality as an organizing influence in “multiple personality” is explored in this paper. Following a brief review of psychoanalytic thinking on sexual trauma and perversion, the author discusses his own views on dissociation and “multiple personality.” A clinical case is then presented in which transsexualism, homosexuality, and sadomasochistic heterosexual practices were manifested during altered ego states. Analysis of the transference revealed the centrality of sadomasochism in this patient. It is hypothesized that various perverse structures may be formed within these seemingly autonomous, amnestic states, in order to contain anxiety and encapsulate the aggression which resulted from early psychic trauma. Issues relating to diagnosis, counter-transference, reconstruction, and psychoanalytic technique are discussed also.If each, I told myself, could but be housed in separate identities, life would be relieved of all that was unbearable …Robert Louis StevensonThe Strange Case of Dr. Jekyll and Mr. Hyde

The history of ideas about perversion is considered, along with an examination of whether the concept is clinically useful. Three cases of varying degrees of severity are presented, illustrating the clinical value of the concept in the analytic situation. All three cases are women, and the particular usefulness of the concept of perversion for women is noted. The place of aggression and the pleasure resulting from its expression are highlighted.

Distinguishing perverse defenses from the concept of obligatory perversion allows perverse defenses to be examined in neurotic patients. Perverse defenses against reality, one's conflicts, and relationships with others are connected with affect intolerance, difficulty with analytic collaboration, and analytic impasse. Perverse defenses, including the cultivation of states of distraction, excitement, and pomposity, as well as perverse sadomasochistic relations with others, protect against the unbearable: intense affects, painful ideas, and loving, committed need of a valued, distinct person. Patients' perverse, vindictive refusal to be reasonable provokes perverse countertransference reactions whereby the analyst stands in judgmentally and critically for the seemingly absent demands of reason, morality, and analytic progress.

In this paper I suggest that the analysis of perversion necessarily involves the elaboration and analysis of a perverse transference countertransference. Both analyst and analysand contribute to and participate in the perverse transference-countertransference which intersubjective construction is powerfully shaped by the perverse structure of the patient's unconscious internal object world. In the fragment of an analysis that is presented, I illustrate the way in which the analyst makes use of his experience in (of) the transference-countertransference in gaining understanding of the perverse scenario that the patient is utilizing as a form of psychic organization, defense, communication, and object relatedness. I discuss the analyst's use of his own unobtrusive, mundane thoughts, feelings, fantasies, ruminations, sensations, and so on, in the service of understanding the perverse transference-countertransference, which understanding is utilized in the formulation of transference interpretations. The perversity of the transference-countertransference is viewed as deriving from the patient's defensive use of particular forms of sexualization as a way of protecting himself or herself against the experience of psychological deadness. Compulsive erotization is understood as representing a method of creating an illusory sense of vitality. The subversion of the recognition of the experience of psychological deadness is achieved in part through compulsively enlisting others in the enactment of exciting, erotized. and often dangerous substitutes for the experience of being alive.

Sadomasochism, an ingredient of infantile sexuality, is an essential part of normal sexual functioning and love relations, and of the very nature of sexual excitement. Sadomasochistic elements are also present in all sexual perversions. Sadomasochism starts out as the potential for erotic masochism in both sexes, and represents a very early capacity to link aggression with the libidinal elements of sexual excitement. Sexual excitement may be considered a basic affect that overcomes primitive splitting of love and hatred. Erotic desire is a more mature form of sexual excitement. Psychoanalytic exploration makes it possible to uncover the unconscious components of sexual excitement: wishes for symbiotic fusion and for aggressive penetration and intermingling; bisexual identifications; the desire to transgress oedipal prohibitions and the secretiveness of the primal scene, and to violate the boundaries of a leasing and withholding object. The relation between these wishes and the development of erotic idealization processes in both sexes is explored in the context of a critical review of the pertinent psychoanalytic literature.

An attempt is made to place bestophilia in cultural, clinical, and theoretical perspective. Archeological and anthropological documentation and records of the widespread appearance in mythology of this practice are cited. This archaic form of perversion is still practiced in rural environments and isolated communities. The treatment of a man who grew up in such an environment gave the author the opportunity to study this form of perversion. The correlation of clinical findings with culturally sanctioned bestophilia provides a bridge between the understanding of psychopatnology and anthropological variation.

Fetishism is generally considered to be a perversion occurring only in males. In this paper a clinical illustration of an adult woman with a fetishistic perversion is offered and considered within the context of the classic concept of fetishism originally described by Freud. Similarities and differences between male and female fetishism are discussed, with attention given to the greater complexity of the perversion as it occurs in a woman. The clinical example confirms the existence of fetishism in women and suggests that subtle forms of the perversion may go unnoticed and be more prevalent than previously realized.

The psychoanalysis of a case of an unusual perversion demonstrated the historical determinants of the ritual. Drive and defense, bisexual disposition, and identifications were represented. At the beginning of the analysis the patient appeared to have borderline character traits; but as the analysis unfolded, an oedipal situation was revealed and character development occurred. The factors that determined the particular outcome for this patient, instead of homosexuality, or transsexualism, are discussed. In some cases of perversion, such as the one herein described, only psychoanalytic exploration can determine whether a level of personality structure and object relations had been reached that allows for the analysis of the perversion and a shift to heterosexuality and mature object relations.